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Badaeva A, Danilov A, Kosareva A, Lepshina M, Novikov V, Vorobyeva Y, Danilov A. Neuronutritional Approach to Fibromyalgia Management: A Narrative Review. Pain Ther 2024:10.1007/s40122-024-00641-2. [PMID: 39042252 DOI: 10.1007/s40122-024-00641-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024] Open
Abstract
Fibromyalgia (FM) is a complex and common syndrome characterized by chronic widespread pain, fatigue, sleep disturbances, and various functional symptoms without clear structural or pathological causes. Affecting approximately 1-5% of the global population, with a higher prevalence in women, FM significantly impacts patients' quality of life, often leading to considerable healthcare costs and loss of productivity. Despite its prevalence, the etiology of FM remains elusive, with genetic, environmental, and psychological factors, including nutrition, being implicated. Currently, no universally accepted treatment guidelines exist, and management strategies are often symptomatic. This narrative review explores the potential of a neuronutritional approach to FM management. It synthesizes existing research on the relationship between FM and nutrition, suggesting that dietary interventions could be a promising complementary treatment strategy. Various nutritional interventions, including vitamin D, magnesium, iron, and probiotics supplementation, have shown potential in reducing FM symptoms, such as chronic pain, anxiety, depression, cognitive dysfunction, sleep disturbances, and gastrointestinal issues. Additionally, weight loss has been associated with reduced inflammation and improved quality of life in FM patients. The review highlights the anti-inflammatory benefits of plant-based diets and the low-FODMAPs diet, which have shown promise in managing FM symptoms and related gastrointestinal disorders. Supplements such as vitamin D, magnesium, vitamin B12, coenzyme Q10, probiotics, omega-3 fatty acids, melatonin, S-adenosylmethionine, and acetyl-L-carnitine are discussed for their potential benefits in FM management through various mechanisms, including anti-inflammatory effects, modulation of neurotransmitters, and improvement of mitochondrial function. In conclusion, this review underscores the importance of considering neuronutrition as a holistic approach to FM treatment, advocating for further research and clinical trials to establish comprehensive dietary guidelines and to optimize management strategies for FM patients.
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Affiliation(s)
- Anastasiia Badaeva
- Department for Pathological Physiology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia.
| | - Alexey Danilov
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
| | - Anastasiia Kosareva
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
| | - Mariia Lepshina
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
| | - Viacheslav Novikov
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
| | - Yulia Vorobyeva
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
| | - Andrey Danilov
- Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia
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Carrasco-Querol N, Cabricano-Canga L, Bueno Hernández N, Gonçalves AQ, Caballol Angelats R, Pozo Ariza M, Martín-Borràs C, Montesó-Curto P, Castro Blanco E, Dalmau Llorca MR, Aguilar Martín C. Nutrition and Chronobiology as Key Components of Multidisciplinary Therapeutic Interventions for Fibromyalgia and Associated Chronic Fatigue Syndrome: A Narrative and Critical Review. Nutrients 2024; 16:182. [PMID: 38257075 PMCID: PMC10818822 DOI: 10.3390/nu16020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Fibromyalgia (FM) is often accompanied by chronic fatigue syndrome (CFS). It is a poorly understood disorder that mainly affects women and leads to chronic pain, fatigue, and insomnia, among other symptoms, which decrease quality of life. Due to the inefficiency of current pharmacological treatments, increasing interest is being directed towards non-pharmacological multicomponent therapies. However, nutrition and chronobiology are often overlooked when developing multicomponent therapies. This narrative and critical review explore the relevance of nutritional and chronobiological strategies in the therapeutic management of FM and the often-associated CFS. Reviewed literature offers scientific evidence for the association of dietary habits, nutrient levels, body composition, gut microbiota imbalance, chronobiological alterations, and their interrelation with the development and severity of symptoms. This review highlights the key role of nutrition and chronobiology as relevant and indispensable components in a multidisciplinary approach to FM and CFS.
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Affiliation(s)
- Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | | | - Nerea Bueno Hernández
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Rosa Caballol Angelats
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Macarena Pozo Ariza
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Carme Martín-Borràs
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Departament de Fisioteràpia, Facultat de Ciencies de la Salut Blanquerna, Universitat Ramón Llull, 08025 Barcelona, Spain
| | - Pilar Montesó-Curto
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
- Departament de Medicina i Cirurgia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili (URV), 43201 Reus, Spain
| | - Elisabet Castro Blanco
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Maria Rosa Dalmau Llorca
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Unitat d’Avaluació i Recerca, Direcció d’Atenció Primària Terres de l’Ebre i Gerència Territorial Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
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Hershkovich O, Hayun Y, Oscar N, Shtein A, Lotan R. The role of cannabis in treatment-resistant fibromyalgia women. Pain Pract 2023; 23:180-184. [PMID: 36333278 PMCID: PMC10100523 DOI: 10.1111/papr.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/11/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fibromyalgia is a complex pain-focused syndrome. Previous studies showed that Cannabis is efficacious in promoting sleep, deepening and lengthening the sleep cycle, and good pain relief (compared with the SSRIs and SNRIs). PURPOSE This study aimed to use the World Health Organization Quality of Life Bref questionnaire (WhoQoL-bref) to characterize the impact of Cannabis Treatment initiation on the quality of life in women suffering from treatment-resistant fibromyalgia. METHODS A prospective cohort study involving 30 women aged 18-70 years old diagnosed with fibromyalgia, exhausted pharmacological fibromyalgia treatment, and started Cannabis treatment. Pregnant women were excluded. WhoQoL-bref was filled before Cannabis treatment initiation and 1 month following treatment. RESULTS Women's average age was 46 years (±5), with a poor general quality of life (1.47 ± 0.63), poor general health (1.47 ± 0.78), pain and discomfort, and dependence on medication (3.77 ± 1.3 and 3.07 ± 1.74, respectively) prior to Cannabis intervention. Cannabis treatment for 30 days showed a marked improvement in general quality of life (1.97 scores, p < 0.01), general health (1.83, p < 0.01), physical health (1.5, p < 0.01), and psychological domain (1.3, p < 0.01). Financial resources and home environment were not influenced by cannabis treatment (p = 0.07, p = 0.31, respectively). CONCLUSION Results suggest a potentially significant role of Cannabis in treatment-resistant Fibromyalgia women. Early Cannabis treatment may result in a beneficial short-term effect on the quality of life through its influence on pain, sleep, and physical and psychological domains. Further studies are still indicated to understand this potential and its long-term beneficial impact.
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Affiliation(s)
- Oded Hershkovich
- Department of Orthopedic Surgery, Wolfson Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv, Israel), Holon, Israel
| | - Yemima Hayun
- Pain Service Unit, Wolfson Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv, Israel), Holon, Israel
| | - Nataly Oscar
- Pain Service Unit, Wolfson Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv, Israel), Holon, Israel
| | - Arnold Shtein
- Pain Service Unit, Wolfson Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv, Israel), Holon, Israel
| | - Raphael Lotan
- Department of Orthopedic Surgery, Wolfson Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv, Israel), Holon, Israel
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Macian N, Dualé C, Voute M, Leray V, Courrent M, Bodé P, Giron F, Sonneville S, Bernard L, Joanny F, Menard K, Ducheix G, Pereira B, Pickering G. Short-Term Magnesium Therapy Alleviates Moderate Stress in Patients with Fibromyalgia: A Randomized Double-Blind Clinical Trial. Nutrients 2022; 14:2088. [PMID: 35631229 PMCID: PMC9145501 DOI: 10.3390/nu14102088] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Patients suffering from fibromyalgia often report stress and pain, with both often refractory to usual drug treatment. Magnesium supplementation seems to improve fibromyalgia symptoms, but the level of evidence is still poor. This study is a randomized, controlled, double-blind trial in fibromyalgia patients that compared once a day oral magnesium 100 mg (Chronomag®, magnesium chloride technology formula) to placebo, for 1 month. The primary endpoint was the level of stress on the DASS-42 scale, and secondary endpoints were pain, sleep, quality of life, fatigue, catastrophism, social vulnerability, and magnesium blood concentrations. After 1 month of treatment, the DASS-42 score decreased in the magnesium and placebo groups but not significantly (21.8 ± 9.6 vs. 21.6 ± 10.8, respectively, p = 0.930). Magnesium supplementation significantly reduced the mild/moderate stress subgroup (DASS-42 stress score: 22.1 ± 2.8 to 12.3 ± 7.0 in magnesium vs. 21.9 ± 11.9 to 22.9 ± 11.9 in placebo, p = 0.003). Pain severity diminished significantly (p = 0.029) with magnesium while the other parameters were not significantly different between both groups. These findings show, for the first time, that magnesium improves mild/moderate stress and reduces the pain experience in fibromyalgia patients. This suggests that daily magnesium could be a useful treatment to improve the burden of disease of fibromyalgia patients and calls for a larger clinical trial.
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Affiliation(s)
- Nicolas Macian
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Christian Dualé
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
- INSERM 1107, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Marion Voute
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Vincent Leray
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Marion Courrent
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Paula Bodé
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Fatiha Giron
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Sylvie Sonneville
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Lise Bernard
- Clinical Research/Temporary Authorization Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Fabienne Joanny
- FJ Recherche et Developpement, Research Organization, 230 Rue du Faubourg Saint-Honoré, F-75008 Paris, France;
| | - Katell Menard
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Gilles Ducheix
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
| | - Bruno Pereira
- Clinical Research and Innovation Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Gisèle Pickering
- Platform of Clinical Investigation Department, INSERM CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (C.D.); (M.V.); (V.L.); (M.C.); (P.B.); (F.G.); (S.S.); (K.M.); (G.D.); (G.P.)
- INSERM 1107, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
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